Complete relief of vasospasm - Effect of nicardipine coating during direct clipping for the patient with symptomatic vasospasm of subarachnoid hemorrhage.

Background: Some patients come to the hospital presenting with ischemic neurological deficits due to postsubarachnoid hemorrhage (SAH) cerebral vasospasm. In such a situation, neurosurgeons tend to avoid direct clipping, since mechanical irritation to the vessels could worsen the vasospasm and exacerbate ischemic symptoms. The optimal timing of direct clipping in patients with evidence of vasospasm is undetermined.

Lumboperitoneal Shunt Surgery Using Valve Implantation on the Paravertebral Spinal Muscle.

Background: One possibly problematic feature of lumboperitoneal shunt (LPS) placement involves inaccuracy in handling the shunt valve compared with ventriculoperitoneal shunt. Flushing the valve to ascertain shunt patency and adjusting the valve pressure in LPS are often more difficult than with ventriculoperitoneal shunt, particularly when the valve is routinely located in abdominal fat. To overcome this inaccuracy, we applied a simple alteration to the usual LPS procedure.

Care at critical care medical centers is associated with improved outcomes in patients with accidental hypothermia: a historical cohort study from the J-Point registry.

Aim: The recommendation that patients with accidental hypothermia should be transported to specialized centers that can provide extracorporeal life support has not been validated, and the efficacy remains unclear.

Methods: This was a multicenter retrospective cohort study of patients with a body temperature of ≤35°C presenting at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into two groups based on the point of care delivery: critical care medical center (CCMC) or non-CCMC.

Does Transport by a Doctor Helicopter Affect Blood Pressure in Stroke Patients?

Objective: Herein we investigate whether transportation by doctor helicopter (DH) affects blood pressure (BP) in stroke patients.

Methods: A total of 119 stroke patients treated by the DH between April 2015 and March 2019 were analyzed. The average BP before and after admission to the DH was compared for all stroke patients.

Effect of Lomerizine Hydrochloride on Preventing Strokes in Patients With Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy.

Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an orphan disease clinically characterized by migraine, recurrent strokes, and dementia. Currently, there are no disease-modifying therapies, and it is difficult to prevent cerebral ischemic events in CADASIL patients by conventional antithrombotic medication. We hypothesized that an antimigraine agent, lomerizine hydrochloride, may prevent strokes in CADASIL patients, based on its effect on increasing cerebral blood flow.

Surgical Management for Craniocervical Junction Arteriovenous Fistula Targeting the Intradural Feeder.

Background: Craniocervical junction arteriovenous fistula (CCJAVF) has a variety of forms, including dural and perimedullary arteriovenous fistulas. Owing to this anatomic variety, the terminologies for classifying CCJAVF, most of which aim to describe angiographic structures, have yet to be firmly established, and the current taxonomic classifications do not facilitate surgical strategies. Herein we focused on the existence of intradural feeder vessels, allowing the identification of 2 types of CCJAVF.

Microvascular decompression for trigeminal neuralgia attributable to the vertebrobasilar artery: decompression technique and significance of separation from the nerve root.

Background: Separation of the vertebrobasilar artery (VBA) from the trigeminal nerve root in microvascular decompression (MVD) is technically challenging. This study aimed to review the clinical features of VBA involvement in trigeminal neuralgia and evaluate surgical decompression techniques in the long term.

Methods: We retrospectively reviewed the surgical outcomes of 26 patients (4.

Aneurysm of Distal Medial Lenticulostriate Artery: Report of 2 Cases.

Background: Aneurysms originating from the distal portion of the lenticulostriate artery (LSA) are uncommon. Distal medial LSA (MLSA) aneurysms are particularly uncommon when compared with distal lateral LSA aneurysms, and their clinical features are unclear. Here, we present 2 patients with aneurysms of the distal MLSA who exhibited hemorrhages of the caudate nucleus and intraventricular region (intraventricular hemorrhage [IVH]).

Managing intervention for severe intraventricular hemorrhage casting in moyamoya disease: Report of two cases.

Introduction: When severe intraventricular hemorrhage (IVH) casting in moyamoya disease (MMD) is mentioned, experts advocate not to evacuate the IVH in acute phase. However, the devastating outcomes derived from this empirical rule have not been addressed. Herein, we report two MMD cases undergoing obliteration of ruptured aneurysm and early complete aspiration of severe IVH casting, and showed good outcomes.

Organized Chronic Subdural Hematoma Treated with Middle Meningeal Artery Embolization and Small Craniotomy: Two Case Reports.

The most preferred treatment for organized chronic subdural hematoma (OSDH) remains controversial. Although a large craniotomy has been reported to be necessary and effective for the treatment of an OSDH, a craniotomy is associated with postoperative hemorrhagic complications and recurrence. Although middle meningeal artery (MMA) embolization has been reported to be effective for a refractory chronic subdural hematoma (CSDH), its efficacy for an OSDH remains unclear.

Fatal Subarachnoid Hemorrhage: A Rare Presentation of Ruptured A2 Dissecting Aneurysm.

Anterior cerebral artery dissection (ACAD), especially simultaneously presenting with subarachnoid hemorrhage (SAH) and cerebral infarction (CI), is rare. Only a few cases of severe SAH due to ACAD have been reported. Herein, we present an unusual case of severe SAH with simultaneous CI caused by ACAD.

Clinical data on rare case of spontaneous disappearance of intracranial Aneurysm.

The data contained within this paper are related to another paper entitled "Rare Spontaneous disappearance of intracranial aneurysm" (Yokoya et al., 2020). Spontaneous disappearance of an unruptured non-giant aneurysm of the anterior circulation is very rare.

Factors Associated with Poor Outcomes in Patients with Mild or Moderate Acute Subdural Hematomas.

The factors influencing the outcomes of mild/moderate acute subdural hematoma (ASDH) are still unclear. Retrospective analyses were performed to identify such factors. The medical records of all patients who were admitted to Saiseikai Shiga Hospital with mild (Glasgow Coma Scale [GCS] score of 14-15) or moderate (GCS score of 9-13) ASDH between April 2008 and March 2017 were reviewed.

Relationship of chronic endometritis with chronic deciduitis in cases of miscarriage.

Background: The presence of chronic deciduitis (CD) was determined in patients diagnosed with or without chronic endometritis (CE) before pregnancy.

Objective: To study the effect of CE on decidua in cases of miscarriage.

Methods: Decidual tissue was obtained from the patients who miscarried at the first pregnancy within a year after the diagnosis of the presence or absence of CE.

Surgical Management of the Trigeminocerebellar Artery in Microvascular Decompression for Trigeminal Neuralgia.

Background: The trigeminocerebellar artery (TCA) is a variant branch of the basilar artery supplying the trigeminal nerve root and cerebellar hemisphere, which may contribute to trigeminal neuralgia (TGN). Despite its unique anatomic description, information regarding the preoperative diagnosis and surgical management of TCA is lacking.

Objective: To evaluate our preoperative diagnosis of TCA using 3-dimensional (3D) images and surgical management of TGN cases with TCA involvement.

Risk Factors for Corneal Endothelial Cell Loss in Patients with Pseudoexfoliation Syndrome.

This study investigated corneal endothelial cell density (ECD) in pseudoexfoliation (PEX) syndrome patients and evaluated the clinical factors associated with ECD for 51 eyes of 41 phakic patients with pseudoexfoliation (PEX group) and 201 eyes of 117 patients with age-related cataracts (control group) as an age-matched control to the PEX group. Variable clinical factors, including ECD, central corneal thickness (CCT), anterior chamber depth (ACD), number of anti-glaucoma eye drops and severity of PEX, were examined using multivariate analyses. Severity of PEX was as follows: Mild in 28 eyes, Moderate in 16 eyes, and Severe in 7 eyes.

Platypnea-Orthodeoxia Syndrome Associated with Spontaneously Ruptured Chordae Tendineae of Tricuspid Valve.

• POS is a rare clinical condition. • Symptoms are upright posture dyspnea and arterial desaturation. • Supine and sitting position oxygen saturation levels suggest right-to-left shunt.

Morphological change and recovery of corneal endothelial cells after rho-associated protein kinase inhibitor eye-drop (ripasudil 0.4%) instillation.

Background/aims: To investigate the time-dependent change of corneal endothelial cell (CEC) morphology and density (CECD) in patients with glaucoma post instillation of rho-associated protein kinase inhibitor ripasudil (Rip) 0.4% eye drops.

Methods: This observational study involved 163 eyes of 163 patients with glaucoma in whom CEC morphological change was evaluated by CECD calculated via non-contact specular microscopy (NCSM) before and at 1 or 3 months post-Rip instillation.

Functional and nutritional outcomes after gastric cancer surgery.

Recent improvements in diagnostic techniques and national screening programs have resulted in increasing number of patients diagnosed with early gastric cancer (EGC). The low incidence rate of lymph node metastasis and excellent survival rates after surgical treatment for EGC enabled the reduction in the extent of lymphadenectomy and the range of gastric resection for function-preserving gastrectomy. Thus, the quality of life (QOL) of patients with gastric cancer (GC) in the curative stage can be maintained.